Provider Demographics
NPI:1336559731
Name:DELVA, KATHY (DDS)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:
Last Name:DELVA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 BATTLEFIELD BLVD N
Mailing Address - Street 2:#4
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-3975
Mailing Address - Country:US
Mailing Address - Phone:757-769-7155
Mailing Address - Fax:
Practice Address - Street 1:200 BATTLEFIELD BLVD N
Practice Address - Street 2:#4
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-3975
Practice Address - Country:US
Practice Address - Phone:757-769-7155
Practice Address - Fax:888-456-0253
Is Sole Proprietor?:No
Enumeration Date:2014-05-07
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401415001122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist